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Pharmacogenomic Testing

The terms pharmacogenetics and pharmacogenomics are currently used interchangeably. However, with the growing understanding that multiple intragenic variations should be considered in making predictions related to medication response, the use of the term pharmacogenomics has become more frequently chosen to designate the process of using documented genetic variation to guide medication selection and dosing.

Historically, psychiatrists have used empirical strategies to select medications. In the best practices, the choice of medications has evolved based on a rational trial-anderror process that has used clinical indicators to select medications and then relied on documenting treatment responses to titrate the optimal dose for a particular patient. Psychiatrists learn to “start low and go slow” in order to minimize side effects. They also know that it is necessary to provide their patients with an “adequate” trial of each medication. Unfortunately, these strategies can result in a 3- to 4-week interval during which the patient continues to experience symptoms. In recent years, the potential iatrogenic harm associated with psychotropic medications has become increasingly obvious, with “black-box warnings” being attached to antidepressants, antipsychotic medications, stimulants, and mood stabilizers.

Despite a growing awareness of this potential harm, there are powerful pressures to try to accelerate the achievement of therapeutic benefit. At the most basic level, patients are impatient. They do not want to wait a month to achieve symptom relief. Pharmacogneomic testing can assist in targeted selection of medication.

At MediBrain, we use several methods of assessment to improve and target medication selectivity for each individual patient. These include rEEG, neurocognitive assessment, pharmacogenomics. Best results are achieved by complete assessment which includes several of these assessment methods as recommended by your psychiatrist at initial examination.